• Journal of Korean Neurosurgical Society
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• v.46 no.6
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• pp.532-537
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• 2009

Objective : Recently, motion preservation has come to the forefront of emerging technologies in spine surgery. This is the important background information of the emergence of cervical arthroplasty as an alternative to arthrodesis that offers the promise of restoring normal spinal movement and reduces a kinematic strain on adjacent segments. The study was designed to evaluate early surgical outcome and radiological effects of $Bryan^{(R)}$ cervical disc prosthesis. Methods : The authors retrospectively reviewed radiographic and clinical outcomes in 52 patients who received the $Bryan^{(R)}$ Cervical Disc prosthesis, for whom follow-up data were available. Static and dynamic radiographs were measured by computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of functional spine unit (FSU), and the C2-7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using Odom's criteria, visual analogue pain scale (VAS) and neck disability index (NDI). Results : A total of 71 $Bryan^{(R)}$ disc were placed in 52 patients. A single-level procedure was performed in 36 patients, a two-level procedure in 13 patients, and a three-level procedure in 3. Radiographic and clinical assessments were made preoperatively. Mean follow-up duration was 29.2 months, ranging from 6 to 36 months. All of the patients were satisfied with the surgical results by Odom's criteria, and showed significant improvement by VAS and NDI score (p < 0.05). The postoperative ROM of the implanted level was preserved without significant difference from preoperative ROM of the operated level (p < 0.05). 97% of patients with a preoperative lordotic sagittal orientation of the FSU were able to maintain lordosis. The overall sagittal alignment of the cervical spine was preserved in 88.5% of cases at the final follow up. Interestingly, preoperatively kyphotic FSU resulted in lordotic FSU in 70% of patients during the late follow up, and preoperatively kyphotic overall cervical alignment resulted in lordosis in 66.6% of the patients postoperatively. Conclusion : Arthroplasty using the $Bryan^{(R)}$ disc seemed to be safe and provided encouraging clinical and radiologic outcome in our study. Although the early results are promising, this is a relatively new approach, therefore long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.

• Journal of Korean Neurosurgical Society
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• v.60 no.6
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• pp.691-700
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• 2017

Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.4
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• pp.447-455
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• 1995

Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.117-128
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• 2013

Objectives The purpose of this study is analyzing internal research trends of abnormal postures and providing problems of researches forward. Methods 6 Korean databases were searched for articles of abnormal postures, irrespective of publication year and 30 research were systematically reviewed. An analytical method such as descriptive statistics and an acutal number and percentage was used. Results We collected 30 studies. 16 studies were published within the last four years. 2012 saw 7 studies, the highest number of studies. Clinical research is the major research method. 26 studies were clinical research. The studies can be categorized according to the characteristic of the research content such as research of related factors or physical characteristics, research of treatment or programs, etc. 16 studies were about research of treatment or programs, the most number of studies. 11 studies were about research of related factors or physical characteristics, and 3 studies were about other issues. Conclusions Since the connection among postural abnormality, pain, and musculoskeletal system disorder has been raising, it is important to conduct a continued, methodical study.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.2
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• pp.85-98
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• 2009

Objectives : The purpose of this study was to find out tendency of traffic accident patients treated in korean medicine hospital. Methods : We investigated 77 patients who were treated in Semyung University Korean Medicine Hospital from 1 st, January, 2007 to the 30st September, 2009. Results and Conclusions : 1. In distribution of gender and age, the rate of male was 36.4%, that of female was 63.6% and majority of patients were twenties, thirties and forties. 2. In the traffic accident patterns, the most was car crash from behind(49.4%) and after traffic accident, 42 patients(54.6%) visited our hospital in less than 5 days. 3. 22 patients(28.6%) choose the oriental medical treatment for primary care. And 35 patients(45.4%) visited our hospital due to preference of oriental medicine. 4. In partial pain, most was the neck(76.6%), followed by low back(61.0%). 5. In radiation test(excluded sprain and straightening), the most was HIVD of L-SPINE(14.0%). 6. In the periods of admission, less than 7 days was the 1st(36.4%), 14 days was the 2nd(27.3%). 7. The treatment was effective to 67 patients out of 77 patients who had been hospitalized.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.359-370
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• 1996

An outbreak of dermatosis occurred at a machine manufacture factory in Kyongju on Aug 1995. Authors conducted a questionnaire ,survey among 92 workers in the factory and a dermatologist examined their skin lesions. Authors also collected moths and identified them. The results are as follows; 1. Forty-two cases of dermatosis were identified with attack rate of 45.7%. Attack rate was not different by company, age, sex, educational level and duration of employment. Attack rate was 47.8% among productive workers, 25.0% among clerical workers and 100.0 % among patrolmen. 2. Two cases among 42 dermatosis cases and three subjects among 50 non-cases had a history of same dermatosis last year. Four of dermatosis cases had a history of dermatosis among their family members. 3. Skin lesions of the cases were scattered or grouped rice-sized erythematous papules or vesicles. Duration of dermatosis from the onset to the time of survey was from one day to more than 30 days. The most frequent site of skin lesion was the arms(81.0 %), and it was also observed at the neck(47.6 %), abdomen(45.2 %), chest(42.9 %), legs(38.1 %) and back(35.7 %). Skin lesion was aggravated with sweating(31.0 %), after shower(16.7 %) and with scratching(11.9 %). 4. Moths were collected and identified as Euproctis subflava (Bremer). Many poisonous stings were observed on their wngs which is harmful to human. 5. Contact with moths' wing droppings to two authors on thier forearms for provocation resulted in severe immediate pain followed by prolonged pruritus. Erythematous macules quickly appeared and succeeded by firm wheal-like red papules. Authors thought that the outbreak of dermatosis was brought about by Euproctis subflava (Bremer). Further studies on the factors contributing to the prosperity of the moths in this area are needed.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.58-62
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• 1994

Superior vena cava(SVC) syndrome is mostly related to a malignant process, but many different benign causes have also been described. We report a case of SVC syndrome caused by Klebsiella pneumonia diagnosed by sputum culture and serial chest X-ray changes. A 27-year-old man had been in stable health until three days before admission, when he complained of pleuritic chest pain, facial flushing, and shortness of breath. Examination of the head and neck disclosed edema of face and both arms, and jugular venous distention to the angle of the jaw. The chest auscultation revealed decreased breath sound without crack1e on right upper lung field. The chest roentgenogram showed homogenous air space consolidation on right upper lobe, asociated with downward displacement of minor fissure and contralateral displacement of trachea, but air bronchogram was not seen. We began antibiotic therapy under impression of pneumonia after available culture was taken from blood and sputum. SVC scintigraphy showed stasis of drain of right brachiocephalic vein at the proximal portion with reflux into the right internal jugular vein and faintly visible SVC via the collaterals. Sputum culture revealed Klebsiella pneumoniae. Antibiotic therapy resulted in a cure of infection and disappearance of facial swelling. Follow-up SVC scintigraphy after 20 days showed normal finding. We first report a case of SVC syndrome caused by klebsiella pneunonia.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.4
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• pp.193-200
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• 2015

Background: During head and neck surgery including orthognathic surgery, mild intraoperative hypothermia occurs frequently. Hypothermia is associated with postanesthetic shivering, which may increase the risk of other postoperative complications. To improve intraoperative thermoregulation, devices such as forced-air warming blankets can be applied. This study aimed to evaluate the effect of supplemental forced-air warming blankets in preventing postanesthetic shivering. Methods: This retrospective study included 113 patients who underwent orthognathic surgery between March and September 2015. According to the active warming method utilized during surgery, patients were divided into two groups: Group W (n = 55), circulating-water mattress; and Group F (n = 58), circulating-water mattress and forced-air warming blanket. Surgical notes and anesthesia and recovery room records were evaluated. Results: Initial axillary temperatures did not significantly differ between groups (Group $W=35.9{\pm}0.7^{\circ}C$, Group $F=35.8{\pm}0.6^{\circ}C$). However, at the end of surgery, the temperatures in Group W were significantly lower than those in Group F ($35.2{\pm}0.5^{\circ}C$ and $36.2{\pm}0.5^{\circ}C$, respectively, P = 0.04). The average body temperatures in Groups W and F were, respectively, $35.9{\pm}0.5^{\circ}C$ and $36.2{\pm}0.5^{\circ}C$ (P = 0.0001). In Group W, 24 patients (43.6%) experienced postanesthetic shivering, while in Group F, only 12 (20.7%) patients required treatment for postanesthetic shivering (P = 0.009, odds ratio = 0.333, 95% confidence interval: 0.147-0.772). Conclusions: Additional use of forced-air warming blankets in orthognathic surgery was superior in maintaining normothermia and reduced the incidence of postanesthetic shivering.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.2.1-2.9
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• 2015

Background: The aim of this study was to evaluate the effect of autogenous tooth bone as a graft material for regeneration of bone in vertical bony defects of the minipigs. Material and Methods: Six minipigs were used in this study. Four molars were extracted in the right mandibular dentition and sent to the Korea Tooth Bank for fabrication of autogenous tooth bone. Ten days later, each extraction site was implanted with MS Implant Narrow Ridge $3.0{\times}10mm$ fixture (Osstem, Seoul, Korea) after standardized 2mm-sized artificial vertical bony defect formation. Pineappleshaped Root-On type autogenous tooth bones were applied to the vertical defects around the neck area of the posterior three fixtures and the fore-most one was not applied with autogenous bone as a control group. Each minipig was sacrificed at 4, 8, 12 weeks after fixture installation and examined radiologically and histologically. Histological evaluation was done under light microscope with Villanueva osteochrome bone staining with semi-quantitative histomorphometric study. Percentage of new bone over total area (NBF) and bone to implant contact (BIC) ratio were evaluated using digital software for area calculation. Result: NBF were $48.15{\pm}18.02%$, $45.50{\pm}28.37%$, and $77.13{\pm}15.30%$ in 4, 8, and 12 weeks, respectively for experimental groups. The control group showed $37.00{\pm}11.53%$, $32.25{\pm}26.99%$, and $1.33{\pm}2.31%$ in 4,8,12 weeks, respectively. BIC ratio were $53.08{\pm}19.82%$, $45.00{\pm}28.37%$, and $75.13{\pm}16.55%$ in 4,8,12 weeks, respectively. Those for the control groups were $38.33{\pm}6.43%$, $33.50{\pm}29.51%$, and $1.33{\pm}2.31%$ in 4, 8, 12 weeks, respectively. Conclusion: Autogenous tooth bone showed higher score than control group in NBF and BIC in all the data encompassing 4,8,12 weeks specimens, but statistically significant only 12 weeks data in both NBF and BIC.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.433-443
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• 1997

Cardiac catheterization is a diagnostic procedure which is intrusive and anxiety provoking. Patient education and information offer have been suggested as effective nursing interventions to reduce patients' anxiety and stress. Main objectives of this study are : 1) to develop concrete objective information for patients undergoing cardiac catheterization : 2) to analyze the types of information included in the newly developed concrete objective information. The subjects of this study are 11 patients who were admitted to the CCU of a general hospital in Seoul. The subjects were provided with preparatory information about cardiac catheterization by using interview and a booklet. After the procedure, the subjects were asked to describe additional information which they suggest to be added into the booklet and the physical sensations felt during the procedure. The results of the study are summarized as follows : Most subjects were satisfied with the preparatory information that was provided by interview and the booklet before the procedure. But patients suggested several problems related to the content of the booklet. First, they reported difficulty to differentiate the terms -coronary angio gram and cardiac catheterization. Also, some patients expressed that they feared after reading the information about the incision of inguinal area. Subjects responded that the information about the direct process of the test did not reduce their anxiety and the information was not detail enough. Next, most subjects would want to know about the monitor and the sound from monitor. They said that they could not hear instructions from doctor or nurse during the procedure due to tension. Considering above response results, the need for more effective way to provide information, like visual and auditory information through video tape for giving information is suggested. Sensations related to the procedure were the smell coming from sterilization of inguinal area, stinging pain in groin when the doctor inserts a needle into artery, and the sensation of pressure and moving of vessels surrounding neck when the catheter was inserted and visualized on fluoroscopy. Besides, subject reported hot sensation and burning feeling in face and chest area, and nausea when dye is injected by hand. In the analysis of information content, there was 79% agreement on the actual units of analysis that were coded. In the analysis of type of information, procedural information was 60.4%. Concrete objective information was 28.1%. and other information was 11.5%. Agreement of the coders in categorizing the units of information was determined by using Cohen's kappa which corrects for chance agreement. Cohen's kappa was .84.